A Case of Subcutaneous Inguinal Abscess Not Complicating Inguinal Hernia That Was Presumed to Be Caused by Secondary to Acute Appendicitis

Abstract

We present the case of a male patient in his 30s who presented to our department with the complaint of a gradually enlarging painful mass in his right inguinal region. Abdominal CT showed a subcutaneous abscess in the right inguinal region measuring approximately 3.5 cm in diameter, with increased fatty tissue content in the inguinal canal and retroperitoneum. A cord-like structure, which appeared to be an appendix, was seen near the inguinal canal, and we made the diagnosis of a subcutaneous abscess in the inguinal region complicating acute appendicitis. The patient was first treated for uncontrolled diabetes mellitus, and the subcutaneous abscess was percutaneously drained with a plan for an elective laparoscopic appendicectomy. Intraoperatively, there was no obvious inguinal hernia, but the appendix was adherent to the lateral inguinal fossa and retroperitoneum. We resected the appendix at the base after performing adhesiolysis. The postoperative course was good, with no recurrence of the abscess. We report a relatively rare case of appendicitis in which the appendiceal inflammation had spread subcutaneously through the inguinal canal to cause a subcutaneous abscess in the inguinal region, with a review of the literature.